Paired Kidney Exchange Update
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Transcript of Paired Kidney Exchange Update
Paired Kidney Exchange Update
October 13, 2012Karen M. Miller
National Kidney RegistryWhy Does it Work?
• Over 60 centers have joined • 538 transplants to date • 308 active donors in the pool• Match runs completed daily
NEAD
D R
DR
BD R
DR
D
Cluster #1
Cluster #2
R
R
R
D
BD
Etc.
Cluster #3
NDD
D R
DR
R
.
Simultaneous Domino Paired Donation
(DPD)
D R
D
WL
Nonsimultaneous Extended Altruistic Donor Chains (NEAD)
Children and High PRA (CHIPS)
• Children--No living donor• Adult--WL > 3 years, Highly
sensitized, past donor, on dialysis• ABO = A, B, AB with greatest chance• Max 50 patients
Match Offer Process
Daily Match Runs
Match Offers
Emailed
Match Acceptance
Emailed
Cross Matches Initiated
Cross Matches
Completed
Surgery Date/Time
Set
Surgeries Performed
1 - 2 Days 10 Days 2-5 Weeks
Match Test Transplant
Pair Match Power
• Pair Match Power is the key to understanding wait time
• Pair Match Power (PMP) is the most accurate predictor of paired exchange wait time and should be used by patients and clinicians to develop individual matching strategies for pairs
How is PMP Calculated?
Rule of Thumb
• If PMP=400+ Pair will match immediately
• If PMP>200 Pair is easy to match• If PMP<100 Pair is hard to match• If PMP=0 Pair nearly impossible to
match
Pos D CtrDonorAlias
R CtrRecipi
entAlias
D-ABO R-ABO D-Age R-AgeRecp
AvoidsPMP CPRA
WaitTime
MatchPoints
PreselectStatus
TargetSurgery
Date
1 PorterAHDBURN0
04Brigham
PA020666
O O 23 45 16 532 72 0 60 Yes n/s
2 Brigham JI060776 UCLA R4737 O O 35 58 3 26 59 0 25 Yes n/s
3 UCLA D4237 JeffersonCARO
SA A 36 43 43 28 99 16 25 Yes n/s
4 Jefferson DIOGS UCSFRE758
BO O 44 39 0 175 0 2 0 Yes n/s
5 UCSF DG759S MadisonMCKE
WO O 60 58 13 65 94 12 25 Yes n/s
6 Madison UNDEJ VAHDBKH03
38O O 57 55 0 61 0 8 60 Yes n/s
7 VAHD JGH8979 StanfordSUR20
50A A 56 28 26 26 97 25 80 Yes n/s
8 Stanford SUD2052 Madison STRAR O O 23 35 6 56 85 5 45 Yes n/s
9 Madison LIPPP O 53
Match Acceptance Deadline: 9/10/12 15:00
UW Update
• Joined NKR 12/2010• 1st paired exchange 2/2011• 17 transplants in 2011• 14 transplants in 2012 (as of 9/24/12)• 4 non directed donors in 2012 (9 in 2011)• 5 highly sensitized patients transplanted
with no desensitization PRA > 85%
• 18 pairs active • 45 CHIP active• 6 active chains • Two chains with three pairs
scheduled
In Summary
• Paired Kidney Exchange works• Gives hope to highly sensitized
patients• Able to use good and willing donors• Able to better inform patients r/t PMP• Many highs and lows